Carla Bruni, Wife of French President Nicholas Sarkozy, Pregnant with Second Child at Age 43

May 19, 2011— -- French President Nicolas Sarkozy's father may have spilled the beans when he told the German newspaper Bild that his daughter-in-law, Carla Bruni-Sarkozy, is pregnant.

"The two do not want to know the gender in advance, but I'm sure it will be a girl and as beautiful as Carla," Pal Sarkozy told the newspaper.

Oops. Oh well. It would have come out sooner or later.

The French first lady had her first son, Aurelien, in 2001, and the French president has three children ranging from 13 to 25 from two previous marriages.

Sarkozy's office staff did not confirm the pregnancy and said that it does not comment on the private and intimate aspects of the Sarkozys' life.

Bruni-Sarkozy is 43. While it is fairly common to see women give birth well into their 40s, doctors say these soon-to-be moms do have a small but increased risk of certain complications of pregnancy.

"Mostly, the risk of pregnancy over 40 is related to underlying disease," said Dr. Alan Peaceman, chief of maternal fetal medicine at Northwestern Memorial Hospital in Chicago. "As we age, the probability of being diagnosed with a serious disease increases, so women in their 40s are more likely to have hypertension, heart disease, and diabetes, among others."

But along with the underlying general health problems, women over 40 are also considered high-risk due to the increased risk of gestational diabetes, high blood sugar that begins during pregnancy; and preeclampsia, a condition in which high blood pressure and protein the urine develop during the second and third trimesters.

"The risk of having a baby with a chromosomal abnormality such as Down syndrome increases, as well," said Peaceman. "Finally, rates of Cesarean delivery increase with maternal age."

According to the March of Dimes, Down syndrome is the most common chromosomal birth defect. At age 40, a woman's risk of having a baby with Down syndrome increases to one in 100 and at age 45, one in 30. The American Congress of Obstetrics and Gynecologists recommends that ob-gyns offer pregnant women of any age a screening test for chromosomal birth defects, including Down syndrome.

But Peaceman said that if a pregnant woman in her 40s is generally healthy and has not been diagnosed with a significant medical condition, the risks are only minimally elevated.

The best way to prepare for pregnancy after 40 is the best way to prepare at any age: stop smoking, achieve a healthy body weight and be physically fit, Peaceman said.

Dr. Jacques Moritz, director of gynecology at St. Luke's-Roosevelt Hospital in New York, said he is quite accustomed to seeing patients Bruni's age. Nearly one quarter of his patients are more than 40 years old.

Despite the risk factors, Moritz said that Bruni-Sarkozy should be just fine.

"Overall, the outcomes at 43 are excellent," said Moritz. "There is no cutoff for pregnancy. Carla will do fine assuming there is only one."